"It's Unjust to Treat Pregnant People this Way": Obstetric Violence Among Pregnant and Postpartum Asylum-seekers at the Mexico-U.S. Border.

To describe asylum-seeking women's perspectives on and lived experiences of obstetric violence, including how it is shaped by structural contexts related to stigma, discrimination, and migration policies and systems. We conducted a qualitative study involving thematic analysis of in-depth interviews conducted July 2022-April 2023 with pregnant and postpartum asylum-seeking women at the Mexico-U.S. border (N = 38). Asylum-seeking pregnant and postpartum women faced obstetric violence across the migration process and within both health and immigration systems. This was experienced in hospitals, immigration detention, and other clinical and non-clinical settings and included denial of timely and responsive care; discriminatory, disrespectful and dehumanizing treatment; physical and verbal abuse; and lack of informed consent for procedures. Women described obstetric violence as frequent, with some attributing this to intersectional stigma and discrimination. Obstetric violence represents a severe violation of the human and reproductive rights of pregnant and postpartum asylum-seekers which requires urgent policy action and intersectoral interventions. Culturally-appropriate, trauma-informed reproductive healthcare, provider sensitivity trainings, changes to immigration policies, and anti-discrimination interventions within and beyond the health system are recommended.